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The ABCs of Proprioception
proprioception: the body’s ability to transmit afferent information regarding position sense, to interpret the information, and to respond consciously or unconsciously to stimulation through appropriate execution of posture and movement
Basic Concepts Basic Concepts of Proprioceptionof Proprioception
Involves agility, balance, and coordination
Targeted after flexibility, strength, and endurance have improved
Components of Proprioception
proprioceptors: afferent nerves that receive and send impulses from stimuli within skin, muscle, joints, and tendons to the central nervous system
An individual’s balance, agility, and coordination are determined by the reception, interpretation, and response that are initiated by proprioceptors.
Proprioceptive ReceptorsProprioceptive Receptors
Cutaneous receptors
Fast-adapting- responsible for vibration senses
Slow-adapting I and II-sensory perception such as skin stretching
Muscle spindles
Muscle and tendon receptors
GTOs
(continued)
Proprioceptive ReceptorsProprioceptive Receptors
Joint receptors
Collaboration of afferent receptors
Ligament receptors
Central Nervous System Central Nervous System Proprioceptor SitesProprioceptor Sites
Spinal cord
Brain stem
Cerebral cortex
balance: the body’s ability to maintain an equilibrium by controlling the body’s center of gravity over its base of support
BalanceBalance
Necessary for static and dynamic activities
Vestibular systemOculomotor system
Sensory input
Influenced by strength and by sensory input from CNS
Proprioceptor system
Balance tests: Romberg, stork stand
Feedback System Feedback System for Coordinationfor Coordination
coordination: the complex process by which a smooth pattern of activity is produced through a combination of muscles acting together with appropriate intensity and timing
CoordinationCoordination
Accomplished through a complex neural network
Strength and proper neural system function are necessary for coordination
Some muscles stimulated and others inhibited
Timing and intensity of muscle response are key
Components Components of Coordinationof Coordination
Activity perception
Inhibition
Feedback
Repetition
Progression Progression of Coordination of Coordination DevelopmentDevelopment
Start with static, simple exercises.
Stop when fatigue, lack of coordination begin to appear.
Progress to dynamic, more complex exercises.
Accuracy of performance is vital in exercise execution.
agility: the ability to control the direction of a body or its parts during rapid movement
AgilityAgility
Requires flexibility, strength, power, speed, balance, and coordination
Activities should resemble the patient’s sport activities
Involves rapid change of direction and sudden stopping and starting
Progression of therapeutic exercise for agility
Therapeutic Exercise Therapeutic Exercise for Proprioceptionfor Proprioception
Balance first, then coordination, then agility
Goal: to perform accurately
Simple to complex
Progression: to more complex, sport-like activities
Initial exercises performed slowly,in controlled situations
Advancement made only after the activity is mastered
Lower-Extremity Lower-Extremity ProgressionProgression
Stork stands: with eyes open, closed; on unstable surfaces; with distracting upper-extremity activity
Sport-specific activities
Dynamic activities: lateral, then change of direction; combined balance, coordination, agility; distracting upper-extremity activitiesPlyometrics
Upper-Extremity Upper-Extremity ProgressionProgression
Passive and active joint repositioning
Sport-specific activities
PNF rhythmic stabilization
Closed kinetic chain stabilizationStraight-plane and multiplane upper-extremity movements
Rubber tubing activities
Plyometrics